I spent last week in Gothenburg, Sweden covering the European Committee for the Treatment of Multiple Sclerosis (ECTRIMS) meeting. Lots of good science, lots of excitement over the new oral and targeted therapies coming on the market to treat this awful disease. But what I want to write about isn’t the science, but about how it will play out in the brave new world of healthcare in which we all live in today.
For instance, consider the first oral therapy to hit the market: Gilenya (fingolimod), which the FDA approved in September. Last month Novartis announced the price: $48,000 a year.
This is not a rant against the high cost of drugs, however. It is a rant against the inability of our healthcare system to take the long view of the impact of such drugs, a view that is particularly important with a chronic disease like MS that strikes healthy young adults in their early 20s and 30s. Read more »
*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*
Times are tight and we’re all looking to save money, be it our own or someone else’s. Many will say that when it comes to the skyrocketing costs of healthcare, doctors are responsible for part of the problem.
Doctors order too many tests, either to cover ourselves in the event of a malpractice suit, or because patients pressure us, or because we genuinely believe that the tests are necessary for patient care, but in many circumstances, a cheaper option is available. We order medications that are expensive when cheaper medications are available. And psychiatrists offer care — like psychotherapy — that could be done by clinicians who are cheaper to educate and willing to work for less money. Read more »
*This blog post was originally published at Shrink Rap*
The essence of the moral hazard experience through a nice neighborly conversation:
Neighbor: These allergies are killing me.
Happy: That’s terrible. I hope you feel better.
Neighbor: I tried Zyrtec but it wasn’t doing anything for me, so my doctor prescribed ’x.’ (inaudible drug name )
Happy: Does it start with an ‘x?’ (The drugs name is Xyzal.)
Neighbor: Yes, it does.
Happy: Oh, that drug (Xyzal) is nothing more than Zyrtec, which the company slightly changed the formula of and now they get to sell it as a patented medication at 10 times the price for the next 10 years.
Neighbor: Oh, I didn’t know that. But you’re right. It was $110.
Happy: Did it help you with your allergies?
Happy: I guess you just wasted $100.
Neighbor. I didn’t waste anything. My insurance company paid for it.
Happy: Actually, we all paid for it with higher premiums.
Neighbor: (Walks away.)
The doctor doesn’t care — he’s not paying for it. The patient doesn’t care — she’s not paying for it. But everyone complains that their insurance rates are out of control. It’s not insurance company profits that are making healthcare too expensive, it’s patients and doctors who don’t care.
Bundled care solves this problem because the doctor won’t prescribe a $110 medication and offer therapies with no proven benefit over less-expensive options.
*This blog post was originally published at The Happy Hospitalist*